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The Nurse Practitioner Salary

You turned in that beautiful resume, you impressed them at your interview, and now they’ve offered you your dream job! They give you an offer, and maybe it’s not nearly as high as you thought it would be, so you ask nicely if they could increase it by a little, they tell you no, that’s all they have in the budget. Well, you tried right? So you take it, then a year later you find out that your coworker with the same experience makes 10% more than you do. Sound familiar?

Maybe it’s because there’s a widespread belief that it’s impolite to talk about money, or maybe it’s because we don’t realize how much we’re really worth, but I find that many of us start out and stay underpaid for the amount of work we do as nurse practitioners. Thus I gift you this collection of everything I’ve found about the nurse practitioner salary, so that when we’re at the negotiating table we are better armed with cold hard data. Then we avoid the above situation from the get go, and we’re all paid fairly, yay! Let’s talk about the green stuff (like those beautiful Korean green tea fields you see above)..

This is a nice breakdown of annual wages, both hourly and annually. When this survey was conducted, there were 122,050 nurse practitioners estimated to be employed, and the average hourly wage was $47.11, and the average annual wage was $97,990. But of course this doesn’t tell us the whole story because we all work in different settings with pretty big variances in salary.

As expected, specialists pay the most, then hospitals, then outpatient care centers. We get paid the least in physician offices, but it is also where we are employed the most, so the variance will be greater, causing the average to be skewed.

But we also live in different cities and states, with varying costs of living.

Here is a nice chart showing the breakdown by state, though if you look at the actual BLS website you can roll your mouse over the state in question and it will give you a nice breakdown further by percentile.

Where are the best paid nurse practitioners? Probably in those nice dark blue states! Here’s the top 5 (I can’t help but blush with West Coast pride):

These big city areas are where we are more likely to be working in:

But we would be better paid in these cities:

I live in the 2nd highest paid metropolitan area, but let me warn you — #2 San Jose and #4 San Francisco are one of the most expensive places to live, period. Columbus, Indiana on the other hand…

If city life isn’t for you, non-metropolitan areas are popular, though they tend to have lower averages. The top paying non-metropolitan areas are Southern Texas, Coastal Oregon (I’m sure I’m not the only one who gets those really beautiful and appealing recruiting emails from Coastal Oregon clinics..), Southeast Alaska, and Western Central North Carolina.

I truly encourage you to look at the BLS site before any negotiation, as I have found it to be the most accurate and comprehensive. [link]

What the BLS survey fails to capture though, is how much we’re paid based on specialty. So here is where the less updated AANP survey comes into play. In May 2011, AANP did a National Nurse Practitioner Compensation Survey. [Side note: hopefully you’re part of AANP, and when you get those survey emails, please respond! It helps improve our understanding of how the profession is playing out in practice. Only approximately 20% of NP’s asked responded to this survey, which makes me think there may be some response bias.]

Based on specialties, it looks like Neonatal NP’s make the most, followed by Psych/Mental Health, Acute Care, and then Adult.

Their data on practice settings is a bit more refined than the BLS one, but it does support the general trend in which Emergency Room/Urgent Care and In-Patient Hospital Units (thus..hospitals) pay better than the average clinic.

If you look further into the AANP data it also gives you a breakdown by how many years of experience you have, but I find that this is more arbitrary, especially after the first couple of years.

You must also take into consideration that places with more training and teaching such as nurse practitioner post-graduate fellowships will pay less in exchange for the additional mentoring they provide.

Note that all of these numbers are averages, so half of us make more, and half of us make less. If you have a lot of years of experience, you should be higher than average. If you’re just a new grad, you probably will be less than average. If you have a lot of skills to offer such as leadership, languages, and procedures, you should be higher than average. If you are expecting a lot of hand-holding in the first year, you should be lower. But whatever the case is for you, it’s good to have a number in the back of your head before you’re in the hot seat of the negotiation table.

Of course salary isn’t everything. If there’s one thing I’ve learned, the people you work with is definitely is more important than anything else. However, many of us are also the type to always want to help and not stress other people out, so it’s easy for employers to throw low balls and we won’t ask for anything more, or only just a tad more, already feeling embarrassed. Shed that fear though. We are making a lot of money for the healthcare industry, and we should be compensated fairly for it. It’s unfortunate, but the more you are paid, the more you tend to be respected.

As a general rule of thumb, it’s appropriate to ask for 10-20% more than what you’re currently making, given your increased experience. The worst thing that can happen is that they’ll say no! If they’ve offered you the job they’ve already decided you’ll be a good fit, and negotiation is expected these days, so make sure you do it.

Hopefully all this information comes at a good time, as I know many of you are looking for jobs and will be at the negotiating table soon. However if you’ve already accepted it, bookmark this so that in the future when you are asking for your annual raise or looking for another job, you’ll be better prepared!

Here are other great resources I’ve found helpful:

A state by state breakdown of NP salaries using data from multiple resources. [link]